Diez Brito Macarena, Sevillano Gonzalo, Negri Florencia, Mongelos Milagros, Izbizky Gustavo
Hospital Italiano de Buenos Aires.
Instituto Universitario Hospital Italiano.
Rev Fac Cien Med Univ Nac Cordoba. 2024 Dec 13;81(4):734-751. doi: 10.31053/1853.0605.v81.n4.44425.
Since its introduction in clinical practice in 1981, pregnancies conceived by assisted reproductive techniques (ART) are an increasing proportion of all pregnancies, presenting particular challenges.
To analyze the maternal-fetal outcomes of pregnancies conceived by ART in a single center in Argentina. Material and methods: Retrospective cohort of pregnancies conceived by ART who attended their delivery in a private university hospital through a review of records.
The incidence of composite primary maternal outcome was 40,1% (282/703), with hypertensive disease of pregnancy (21%) being the most frequent presenting pathology.In the multivariate analysis, age > 40 (OR 2,79; 95%CI: 1,82-4,26), chronic hypertension (OR 10,59; 95% CI: 2,81-39,86), twin pregnancy (OR 8,94; 95% CI: 5,39 – 14,80) and oocyte donation (OR 1,54; 95% CI: 1,04 – 2,27) were significantly associated with the maternal primary outcome. The incidence of the composite neonatal fetal primary outcome was 56,7% (468/824), with a prematurity rate of 34,5% (252/803). In the multivariate analysis of the composite outcome of the neonatal fetus, twin pregnancy (OR 7,08; 95% CI: 3,48 – 14,39) and other complications related to prematurity were statistically significantly associated with the composite outcome.
Pregnancies conceived by ART show a significant increase in adverse maternal outcomes, mainly hypertension, and fetal and neonatal outcomes (prematurity, malformations, and admission to the intensive care unit).
自1981年辅助生殖技术(ART)应用于临床实践以来,通过该技术受孕的妊娠在所有妊娠中所占比例日益增加,带来了特殊挑战。
分析阿根廷某单一中心通过ART受孕的妊娠的母胎结局。材料与方法:通过回顾记录,对在一家私立大学医院分娩的ART受孕妊娠进行回顾性队列研究。
复合主要孕产妇结局的发生率为40.1%(282/703),妊娠高血压疾病(21%)是最常见的病理表现。在多因素分析中,年龄>40岁(OR 2.79;95%CI:1.82 - 4.26)、慢性高血压(OR 10.59;95%CI:2.81 - 39.86)、双胎妊娠(OR 8.94;95%CI:5.39 - 14.80)和卵母细胞捐赠(OR 1.54;95%CI:1.04 - 2.27)与孕产妇主要结局显著相关。复合新生儿胎儿主要结局的发生率为56.7%(468/824),早产率为34.5%(252/803)。在新生儿胎儿复合结局的多因素分析中,双胎妊娠(OR 7.08;95%CI:3.48 - 14.39)和其他与早产相关的并发症与复合结局在统计学上显著相关。
通过ART受孕的妊娠显示出不良孕产妇结局显著增加,主要是高血压,以及胎儿和新生儿结局(早产、畸形和入住重症监护病房)。